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Featured researches published by Han-Nan Liu.


Acta Dermato-venereologica | 2010

Prevalence of atopic dermatitis, allergic rhinitis and asthma in Taiwan: a national study 2000 to 2007.

Chian-Yaw Hwang; Yi-Ju Chen; Ming-Wei Lin; Tzeng-Ji Chen; Szu-Ying Chu; Chih-Chiang Chen; Ding-Dar Lee; Yun-Ting Chang; Wen-Jen Wang; Han-Nan Liu

To study the prevalence of atopic dermatitis, allergic rhinitis, and asthma in Taiwan, we analysed the claims data of a nationally representative cohort of 997,729 enrolees from the National Health Insurance register from 2000 to 2007. Overall, 66,446 patients were diagnosed with atopic dermatitis, and 49.8% of them had concomitant allergic rhinitis and/or asthma. The overall 8-year prevalences of atopic dermatitis, allergic rhinitis, and asthma were 6.7%, 26.3% and 11.9%, respectively. Children and adolescents had significantly higher prevalences of these atopic diseases. The prevalence of atopic dermatitis in females was lower than that in males before the age of 8 years, but became higher after that. Patients with atopic dermatitis were more likely to have allergic rhinitis and asthma. Those having both atopic dermatitis and allergic rhinitis possessed an even higher risk for asthma (odds ratio 9.04). The numbers of visits for atopic dermatitis were highest in late spring to mid-summer. These data suggest that atopic diseases are common in Taiwan.


Journal of The American Academy of Dermatology | 2011

Comorbidity profiles among patients with alopecia areata: the importance of onset age, a nationwide population-based study.

Szu-Ying Chu; Yi-Ju Chen; Wei-Cheng Tseng; Ming-Wei Lin; Tzeng-Ji Chen; Chian-Yaw Hwang; Chih-Chiang Chen; Ding-Dar Lee; Yun-Ting Chang; Wen-Jen Wang; Han-Nan Liu

BACKGROUND Alopecia areata (AA) is considered an autoimmune disease with undetermined pathogenesis. Age at onset predicts distinct outcomes. A nationwide study of the relationship of AA with associated diseases stratified by onset age has rarely been reported. OBJECTIVE We sought to clarify the role of atopic and autoimmune diseases in AA, thereby better understanding its pathogenesis. METHODS A total of 4334 patients with AA were identified from the National Health Insurance Database in Taiwan from 1996 to 2008. A national representative cohort of 784,158 persons served as control subjects. RESULTS Among patients with AA, there were significant associations with vitiligo, lupus erythematosus, psoriasis, atopic dermatitis, autoimmune thyroid disease, and allergic rhinitis. Different ages at onset resulted in disparate comorbidities. Increased risk of atopic dermatitis (odds ratio [OR] 3.82, 95% confidence interval 2.67-5.45) and lupus erythematosus (OR 9.76, 95% confidence interval 3.05-31.21) were found in childhood AA younger than 10 years. Additional diseases including psoriasis (OR 2.43) and rheumatoid arthritis (OR 2.57) appeared at onset age 11 to 20 years. Most atopic and autoimmune diseases were observed at onset ages of 21 to 60 years. With onset age older than 60 years, thyroid disease (OR 2.52) was highly related to AA. Moreover, patients with AA had higher risk for more coexisting diseases than control subjects. LIMITATIONS We could not differentiate hypothyroidism from hyperthyroidism. CONCLUSIONS AA is related to various atopic and autoimmune diseases. Different associated diseases in each onset age group of AA can allow clinician to efficiently investigate specific comorbidities.


Acta Dermato-venereologica | 2009

Epidemiological study of psoriasis in the national health insurance database in Taiwan.

Yun-Ting Chang; Tzeng-Ji Chen; Pei-Chi Liu; Yu-Chun Chen; Yi-Ju Chen; Yu-Lin Huang; Jaw-Shyang Jih; Chih-Chiang Chen; Ding-Dar Lee; Wen-Jen Wang; Ming-Wei Lin; Han-Nan Liu

The aim of this study was to determine the prevalence, treatment modalities and comorbidity of psoriasis in Taiwan. A nationally representative cohort of 1,000,000 individuals from the National Health Insurance database was followed up for the years 2000 to 2006. Their claims data was used for an epidemiological study. The mean one-year prevalence of psoriasis was 0.23% for men and 0.16% for women, respectively. The prevalence of psoriasis increased more rapidly in male patients aged 30 years and over and reached its peak in patients aged 70 years and over, regardless of sex. Overall, 98.4% of patients received treatment with topical corticosteroids, while 13.1% used Chinese herbal medicines and 13.6% received systemic treatment. Patients with psoriasis had a higher comorbidity of diabetes, hyperlipidaemia, and hypertension. In conclusion, in contrast to Caucasians, the prevalence of psoriasis in Taiwanese people is high er in men than in women and the prevalence increases significantly in patients over 70 years of age.


Acta Dermato-venereologica | 2009

Epidemiological Features and Costs of Herpes Zoster in Taiwan: A National Study 2000 to 2006

Jaw-Shyang Jih; Yi-Ju Chen; Ming-Wei Lin; Yu-Chun Chen; Tzeng-Ji Chen; Yu-Lin Huang; Chih-Chiang Chen; Ding-Dar Lee; Yun-Ting Chang; Wen-Jen Wang; Han-Nan Liu

To analyse the epidemiological characteristics and related costs of herpes zoster in Taiwan, a nationally representative cohort of 1,000,000 individuals from the National Health Insurance register was followed up from 2000 to 2006 and their claims data analysed. Overall, 34,280 patients were diagnosed with zoster (incidence 4.89/1000 person-years) and 2944 patients (8.6%) developed post-herpetic neuralgia 3 months after the start of the zoster rash (incidence 0.42/1000 person-years). People with older age, diabetes, and immunocompromising conditions were at higher risk of developing zoster and post-herpetic neuralgia. The overall hospitalization rate for zoster was 16.1 cases per 100,000 person-years. The cost for each home care case and per hospitalized case were approximately 53.30 euro and 1224.70 euro, respectively. Further research into the cost-effectiveness of zoster vaccine is needed.


International Journal of Cancer | 2012

Cancer risk in patients with allergic rhinitis, asthma and atopic dermatitis: a nationwide cohort study in Taiwan.

Chian-Yaw Hwang; Yi-Ju Chen; Ming-Wei Lin; Tzeng-Ji Chen; Szu-Ying Chu; Chih-Chiang Chen; Ding-Dar Lee; Yun-Ting Chang; Wen-Jen Wang; Han-Nan Liu

It has long been a debate that whether atopy is a risk factor or protective factor for cancer. However, no large‐scale study of different cancers in patients with atopic diseases has been conducted among Asians. Here, we conducted a nationwide study to evaluate the cancer risk in patients with allergic rhinitis (AR), asthma and atopic dermatitis (AD). Drawing on Taiwans National Health Insurance Research Database, 225,315 patients with AR, 107,601 patients with asthma and 34,263 patients with AD without prior cancers were identified in the period from 1996 to 2008. The standard incidence ratio (SIR) of each cancer was calculated. Although the overall cancer risks in patients with atopic symptoms were not increased, the risks were slightly elevated in female patients with AR or asthma (SIR: 1.13 and 1.08, AR and asthma, respectively) and slightly decreased in males patients with AR. Those aged 20–39 years‐old possessed the highest risk. A higher risk of developing brain cancer was found in patients with atopic diseases, and patient with AR or asthma also had an elevated risk of developing cancer of kidney and urinary bladder. In contrast, the risk of nonmelanoma skin cancer was lower in patients with AR and asthma. Compared to patients with only one atopic disease, those with more than one atopic disease had lower cancer risks. Our data suggests that the association between atopy and cancer is site‐specific.


British Journal of Dermatology | 2003

A study of candidate genes for psoriasis near HLA‐C in Chinese patients with psoriasis

Yun-Ting Chang; Shih-Feng Tsai; Ding-Dar Lee; Yu-Ming Shiao; Chiu-Jung Huang; Han-Nan Liu; Wen-Jen Wang; Wong Ck

Summary Background Genetic analyses have identified the HLA‐Cw6 allele as the major risk allele for psoriasis in many racial groups. However, by serological typing, HLA‐Cw6 is not considered a risk factor in Chinese psoriatics. There are several susceptibility genes for psoriasis residing in chromosome 6p near the HLA‐C locus, including the corneodesmosin (CDSN) gene, the octamer transcription factor‐3 (POU5F1) gene, the major histocompatibility complex class I chain‐related gene A (MICA), and the gene for tumour necrosis factor (TNF)‐α. However, the information about their role in psoriasis in Chinese patients is limited.


The American Journal of Medicine | 2013

Increased Risk of Acute Myocardial Infarction in Systemic Sclerosis: A Nationwide Population-based Study

Szu-Ying Chu; Yi-Ju Chen; Chia-Jen Liu; Wei-Cheng Tseng; Ming-Wei Lin; Chian-Yaw Hwang; Chih-Chiang Chen; Ding-Dar Lee; Tzeng-Ji Chen; Yun-Ting Chang; Wen-Jen Wang; Han-Nan Liu

PURPOSE Systemic sclerosis is a life-threatening autoimmune disease characterized by vasculopathy, which results in myocardial involvement in an extremely high percentage of patients. Nevertheless, there have been no large-scale epidemiological studies about the risk of acute myocardial infarction in patients with systemic sclerosis. The aims of this study were to evaluate the hazard ratio (HR) and risk factors of acute myocardial infarction in patients with systemic sclerosis, as well as to compare the risks of acute myocardial infarction among systemic sclerosis patients taking different immunosuppressors. METHODS The study cohort included 1344 patients with systemic sclerosis and 13,440 (1:10) age-, sex-, and comorbidity-matched controls during the period between 1997 and 2006, from the National Health Insurance Research Database. We compared the risk of acute myocardial infarction between patients with systemic sclerosis and controls and calculated the adjusted HRs for acute myocardial infarction in systemic sclerosis patients taking immunosuppressors and not taking immunosuppressors. RESULTS The incidence rates of acute myocardial infarction were 535 and 313 cases per 100,000 person-years for systemic sclerosis cohort and reference cohort, respectively (P <.001, unadjusted). After adjusting for age, sex, and underlying medical diseases on Cox proportional hazards model, systemic sclerosis was found to be an independent risk factor for acute myocardial infarction (HR 2.45). Other risk factors included hypertension (HR 2.08) and diabetes (HR 2.14). The multivariate adjusted HR for acute myocardial infarction did not decrease among the systemic sclerosis patients taking systemic steroids, penicillamine, cyclophosphamide, azathioprine, methotrexate, or cyclosporine. CONCLUSION Systemic sclerosis is independently associated with an increased risk of acute myocardial infarction. Immunosuppressors do not lower the risk of acute myocardial infarction in our study.


Journal of The American Academy of Dermatology | 2015

Cardiovascular comorbidities in patients with rosacea: A nationwide case-control study from Taiwan.

Tuan-Chun Hua; Pei-I Chung; Yi-Ju Chen; Lung-Chi Wu; Yen-Da Chen; Chian-Yaw Hwang; Szu-Yin Chu; Chih-Chiang Chen; Ding-Dar Lee; Yun-Ting Chang; Han-Nan Liu

BACKGROUND Rosacea is a chronic inflammatory skin disease. Inflammation plays a prominent role in atherosclerosis and its complications. OBJECTIVE We sought to investigate the associations of rosacea with cardiovascular disease risk factors and cardiovascular diseases from a nationwide population-based database. METHODS A total of 33,553 patients with rosacea and 67,106 age- and gender-matched control subjects were identified from the National Health Insurance Research Database in Taiwan from 1997 to 2010. Multivariate logistic regressions were performed to compare the odds of comorbidities between the 2 groups. RESULTS Dyslipidemia (odds ratio 1.41; 95% confidence interval 1.36-1.46), coronary artery disease (odds ratio 1.35, 95% confidence interval 1.29-1.41), and hypertension (odds ratio 1.17, 95% confidence interval 1.12-1.21) were significantly associated with rosacea. Coronary artery disease remained independently associated with rosacea after adjustment for hypertension, diabetes mellitus, and dyslipidemia. Male patients with rosacea had higher risks for all comorbidities than female patients with rosacea. LIMITATIONS The National Health Insurance Research Database does not contain information regarding rosacea subtypes or disease severity, or laboratory data. CONCLUSION Patients with rosacea are more likely to have dyslipidemia and hypertension. They are also at increased risk of coronary artery disease after adjustment for cardiovascular disease risk factors.


Nephrology Dialysis Transplantation | 2012

Malignancies after renal transplantation in Taiwan: a nationwide population-based study

Wei-Hsuan Li; Yi-Ju Chen; Wei-Cheng Tseng; Ming-Wei Lin; Tzeng-Ji Chen; Szu-Ying Chu; Chian-Yaw Hwang; Chih-Chiang Chen; Ding-Dar Lee; Yun-Ting Chang; Wen-Jen Wang; Han-Nan Liu

BACKGROUND Renal transplantation has been regarded as the treatment of choice for end-stage renal disease. Renal transplantation increases the risk of cancers due to long-term immunosuppression. The types of post-transplantation malignancies may vary among different geographic regions and ethnic populations. To date, large population-based studies of post-transplantation malignancies in Asian renal transplant recipients (RTRs) have rarely been reported. METHODS To investigate the patterns of post-transplantation malignancies in Chinese RTRs, we performed a nationwide population-based cohort study between 1997 and 2008 based on data from the National Health Insurance Database in Taiwan. Patterns of cancer incidence in RTRs were compared with those of the general population using standardized incidence ratios (SIRs). RESULTS Among the 4716 RTRs (2475 males and 2241 females; mean age 44.1 ± 12.4 years) and 22 556 person-years of observation, 320 post-transplant cancers were diagnosed. The SIR of all cancers was 3.75 (95% confidence interval 3.36-4.18). Women had a higher risk than men for the development of malignancies (SIR 5.04 for women and SIR 2.88 for men). Renal, bladder and liver cancers were the most common cancers, with SIRs of 44.29, 42.89 and 5.07, respectively. When stratified by age, RTRs of young age at transplant (<20 years) had the highest risk of post-transplantation malignancies. CONCLUSIONS This study demonstrates different patterns of malignancies after renal transplantation in Chinese RTRs, with higher incidences of kidney and bladder cancers. Physicians should be more vigilant in examining RTRs for post-transplantation malignancies especially in younger patients.


Journal of The Chinese Medical Association | 2007

Uveitis with biopsy-proven sarcoidosis in Chinese--a study of 60 patients in a uveitis clinic over a period of 20 years.

Yu-Mei Chung; Ying-Cheng Lin; Yin-Tzu Liu; Shi-Chuan Chang; Han-Nan Liu; Wen-Hu Hsu

Background: The aim of this study was to assess the clinical features of uveitis with biopsy‐proven sarcoidosis in Chinese patients. Methods: This was a retrospective study of uveitis patients with biopsy‐proven sarcoidosis who consecutively visited the uveitis clinic of Taipei Veterans General Hospital from 1986 to 2005. Medical records were reviewed to obtain demographic data, initial symptoms, biopsy sites, pulmonary conditions detected by chest X‐ray and manifestations of uveitis. From 2002 onwards, patients also received chest computed tomography (CT). Results: A total of 60 uveitis patients with biopsy‐proven sarcoidosis were identified. Forty‐four patients (73%) were found in the last 4 years. Female predominance with a male‐to‐female ratio of 1:6.5 was found. The most common initial symptom was uveitis in 41 patients (68%). The most common positive biopsy sites were mediastinal lymph nodes, lung, conjunctiva and skin. Twenty (90.9%) of 22 patients with chest X‐ray stage 0 showed 3 stage 1 on CT. The mean age at uveitis onset was 47.7 ± 14.7 years (range, 21–76 years), with no gender difference (p = 0.913). A peak incidence was found in the 6th decade of life. There was bilateral eye involvement in 54 patients (90%). Frequency of the manifestations of uveitis showed isolated anterior uveitis in 2 patients (3.3%), isolated posterior uveitis in 8 patients (13.3%), intermediate and posterior uveitis (i.e. anterior uveitis sparing) in 16 patients (26.7%), and panuveitis in 34 patients (56.7%). Conclusion: A marked increase was noted since 2002. One of the causes is the performance of chest CT. Chest CT is useful to discover mediastinal lymphadenopathy and other lesions suggestive of sarcoidosis, as well as to help guide tissue confirmation in patients with peculiar uveitis features indicative of sarcoidosis. Female predominance and peak incidence of uveitis onset in the 6th decade of life were found. The posterior segment was the most common localization of uveitis in biopsy‐proven sarcoidosis in Chinese.

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Yun-Ting Chang

Taipei Veterans General Hospital

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Chih-Chiang Chen

Taipei Veterans General Hospital

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Ding-Dar Lee

Taipei Veterans General Hospital

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Yi-Ju Chen

National Yang-Ming University

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Chian-Yaw Hwang

National Yang-Ming University

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Wen-Jen Wang

Taipei Veterans General Hospital

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Tzeng-Ji Chen

Taipei Veterans General Hospital

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Ming-Wei Lin

National Yang-Ming University

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Szu-Ying Chu

Taipei Veterans General Hospital

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Yen-Da Chen

Taipei Veterans General Hospital

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